Increase text size: A A A

Type in the condition you need,
or visit Advanced Search

Print this page

Email this to a friend

Comment on this page

Save to my Health Library

Johns Hopkins Health Alert

Drugstore Aisle Updates on Warfarin, DHEA, Black Cohosh

Johns Hopkins Health Alerts | Prescription Drugs | Updates on Warfarin, DHEA, Black Cohosh

On Warfarin and Herbal Supplements -- If you use warfarin, you already know the rules for dealing with food and drug interactions: Don’t start or stop taking any other medications without telling your doctor, keep the amount of vitamin-K-rich foods that you eat consistent, and carry a medical ID card or bracelet to inform emergency personnel that you’re taking warfarin.

What you may not know is that taking herbal supplements can affect the way that warfarin works.

Herbal supplements that enhance warfarin’s effects:

  • Garlic (in supplement form only)
  • Ginger (in supplement form only)
  • Feverfew
  • Dong quai (Chinese angelica)
  • Ginkgo biloba. This supplement is particularly dangerous. Taken alone, it can cause bleeding; the risk is even higher when combined with warfarin.

Herbal supplements that reduce warfarin’s effects:

  • Ginseng
  • St. John’s wort

Talk to your doctor before you use any type of supplement. Some may be safe to use while you’re taking warfarin, but your warfarin dose may need to be adjusted. And be prepared to monitor your INR more frequently until you know exactly how the supplement affects you.

On DHEA -- Over-the-counter supplements of the hormone dehydroepiandrosterone (DHEA) have been touted as a fountain of youth. But a double-blind, placebo-controlled study of 144 men and women over age 60 found otherwise. Subjects who received DHEA for two years were tested for improvements in peak oxygen level, muscle strength, and insulin sensitivity. Results were no different than those from people taking placebo. A small increase in bone mass density was seen, but it was well below the increases produced by osteoporosis drugs. The study was reported in The New England Journal of Medicine (October 19, 2006, p. 1647).

On Black Cohosh -- The herb black cohosh was no better than placebo for treating hot flashes associated with menopause, according to a controlled study of 351 women ages 45–55. The study, reported in the Annals of Internal Medicine (December 19, 2006, p. 869), is the longest and largest study of black cohosh and menopausal symptoms to date.

For more Alerts and Special Reports, please visit the Prescription Drugs Topic page.

Johns Hopkins Health Alerts | Prescription Drugs | Updates on Warfarin, DHEA, Black Cohosh

Posted in Prescription Drugs on May 8, 2007

Comments

Post a Comment

Users and editors may post comments here at their own discretion. The views expressed do not constitute medical advice and do not represent the position of Johns Hopkins Medicine or University Health Publishing, which has no responsibility for its content.


As a long-time user of some herbal supplements, I always tell my doctor if a prescription drug is suggested. Having said that, this article, I feel, goes a little over-board with the suggestion that Ginko Bilboa is a "dangerous" herb - that it can cause bleeding. I've taken Ginko for 20 years with absolutely no ill effects. Ginko is reported to be a blood thinner (like asprin) but I take asprin also (have for 40+ years).I believe that it has enabled me to remain reasonably mentally fit at the ripe age of 68 - very few lapses in memory if any and I seem to be able to recall names and phone numbers from decades ago. By the way, another leading medical center is testing Ginko's possible effectiveness with dementia patients. Some delaying of the onset of this disease has been reported by them.

Posted by: ffoegler | May 8, 2007

A very thorough review of the effects of gingko upon the body, and when taken in conjunction with other medicines, including warfarin and aspirin, can be found at the American Academy of Family Physicians website at http://www.aafp.org/afp/20030901/923.html.

This article gives a round-up, albeit not very thorough, of the 50 or so studies to date on gingko, and further ongoing clinical trials in progress, which I am sure Hopkins' specialists will be watching closely and reporting on in due course.

In the same way that not everyone can take aspirin safely, not everyone can take gingko safely, and as will all herbal supplements, there is very little quality or dosage control as to what is claimed on the label, versus what is in the pill itself, versus what you are putting in your body.

The 'warning' nature of the message, I am sure, is also for people who never think to mention vitamins and supplements they are taking, or assume because it is a 'natural' remedy, that it is completely harmless. As this article points out, Vitamin K and even green leafy vegetables can be potentially dangerous! if not regulated in conjunction with warfarin intake, which need to be monitored on a regular basis.

As always, the take home message here is to stay as informed as possible, and work as closely with your doctor as possible.

Many thanks for another very useful article!

Posted by: Jo | May 10, 2007



Post a Comment


New to the Johns Hopkins Health Alerts?
Signup

User Name:


This appears next to your comment.


Email Address:

(this will not be posted)
This will be your login ID.

Password:

Confirm Password:


Receive Health Alerts?

Notify me when new comments are posted?

Comment (offensive materials and/or spam will be removed, no HTML allowed)

Already a subscriber?
Login

Email:

Password:


Forgot your password?

Registered Users Log-in:

Email:

Password:

Remember me
Forgot Password?

Become a Registered User!
It's fast and FREE!
The Benefits of Being A Registered User

Health Topic Pages

Arthritis +Add
Back Pain & Osteoporosis +Add
Caregivers | Caregiving
Colon Cancer +Add
Complementary Medicine
Depression & Anxiety +Add
Diabetes +Add
Digestive Health +Add
Exercise and Fitness
Healthy Living +Add
Heart Health +Add
Hypertension & Stroke +Add
Lung Disorders +Add
Memory +Add
Men's Health
Nutrition +Add
Prescription Drugs +Add
Prostate Disorders +Add
Sexual Health
Vision +Add
Weight Control +Add
Women's Health
Health Alert Special Report


Johns Hopkins Bestsellers:
Prescription Drugs

Johns Hopkins White Papers
  • 2008 Prescription Drugs White Paper
    Used inappropriately, prescription medicines may not help very much and can even cause harm. Understanding how prescription medicines are created, tested, marketed, and dispensed is important in order to maximize their benefits and minimize their risks. This White Paper will help you to be a more informed consumer of prescription drugs. It cannot tell you which medications are best for you; your doctor and/or pharmacist will offer guidance in using your own prescription drugs safely, cost-effectively, and to your greatest benefit. What you learn from this document will help you to ask the right questions and have a better understanding of the answers.
    Read more or order the INSTANT PDF DOWNLOAD EDITION
    Read more or order the PRINT EDITION

    Johns Hopkins Consumer Guide To Drugs Cover

  • The Johns Hopkins Consumer Guide to Drugs
    Contains drug profiles on more than 750 medications–both prescription and over-the-counter, most commonly used by people over 50, all presented in our unique page-at-a-glance format, designed with you in mind, the busy person who wants the most reliable health information available at your fingertips. Your guide also includes an invaluable overview of dietary supplements and how they can interact with certain medications, the dangers of taking your pills with grapefruit juice, and more. Because you owe it to yourself to know everything you can about the medicines you take.Read more...

  • The Johns Hopkins Medical Letter: Health After 50
    Since 1988, Hopkins experts have been reporting the latest cutting-edge information on treating the major medical conditions affecting those over 50. Women's health, men's medical concerns, nutrition, weight control, breakthroughs, new medications, and more, direct to you every month from our specialists. Read more, collect your FREE trial issue, or order now and receive two FREE Special Reports...

    Reference Books

    Johns Hopkins Medical Guide to Health after 50

  • The Johns Hopkins Medical Guide to Health After 50
    A comprehensive home medical encyclopedia that gives you a “crash course” on more than 100 major medical concerns of men and women over 50! Organized in an easy-to-use A to Z format, the Medical Guide provides in-depth explanations of the many chronic health problems associated with aging – high blood pressure, stroke, high cholesterol, coronary heart disease, Alzheimer's disease, diabetes, osteoarthritis, dementia, memory loss, prostate cancer, breast cancer, and gallstones, to name but a few.Read more or order...

    Johns Hopkins Symptoms and Remedies

  • Johns Hopkins Symptoms and Remedies
    This easy-to-use reference book can help you pinpoint the causes of hundreds of disorders, from abdominal pain to skin rash to swollen glands. The book is divided into two distinct sections: symptoms, which includes charts covering a wide range of common symptoms and possible diagnoses, and disorders, which discusses the disorder, its causes, prevention advice, treatment strategies, and other crucial information so you will be able to either treat yourself at home, or know when it's time to call a doctor. Read more or order...


  • COME SEE WHAT'S NEW IN THE BOOKSTORE!


    ALL NEW!Number One of America's Best Hospitals 2007: Johns Hopkins

    Johns Hopkins has been ranked #1 again in the Honor Roll of America's Best Hospitals by
    U.S. News and World Report for the 17th consecutive year.


    Please visit here for more information about Johns Hopkins Patient Services

    Please send me The Johns Hopkins Consumer Guide to Drugs



    Yes! Please send me The Johns Hopkins Consumer Guide to Drugs for just $29.97, plus shipping and handling. I may review it risk-FREE for 30 days. If not completely satisfied, I may return the book, no questions asked.


    A contemporary drug encyclopedia for your home with the authority of America's #1 medical center behind it.

  • Has your pharmacy given you the right medication?
  • Are there alternate drugs for your condition that might have fewer side effects?
  • Is an herbal supplement likely to interact adversely with your medications?

    This fully illustrated guide contains drug profiles on more than 750 medications—both prescription and over-the-counter, mostly commonly prescribed for the over 50 population. It also includes a guide to dietary supplements.

    Order today! Because you owe it to yourself to know everything you can about the medicines you take.


  • Risk-FREE.
    Fill out the form and click "Submit my order."

    First Name

    Last Name

    Address

    Address2

    City

    State

    Zip

    Email Address (required)

    Please send me FREE monthly Johns Hopkins Healthy Living Health Alerts

    Your risk-free review. Yours to review risk-free. If you are not satisfied with The Johns Hopkins Consumer Guide to Drugs for any reason, simply return the book, no questions asked.

    Why Johns Hopkins?



    © 2008 Medletter Associates, LLC. All rights reserved.
    Contact Us
    customerservice@johnshopkinshealthalerts.com